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HomeMy WebLinkAbout109888 INSITUFORM TECHNOLOGIES INC - INSURANCE CERTIFICATE (5)ACORD. CERTIFICATE OF LIABILITY INSURANCE 7/1/2010 DATE (MM/DD/YYYY) 6/29/2009 PRODUCER Lockton Companies,LLC-1 St. Louis Three City Place Drive, Suite 900 St. Louis MO 63141-7081 (314) 432-0500 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Insituform Technologies, Inc. 1041932 17988 Edison Avenue Chesterfield MO 63005 INSURERA: Liberty Mutual Fire Insurance Company (64) 23035 INSURER B: Liberty Insurance Corporation (64) 42404 INSURER C : INSURER D : INSURER E : COVERAGES 11 STE02 29 THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING HIS AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADDT INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DDIYY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 21000,000 A X COMMERCIAL GENERAL LIABILITY TB2-641-004218-039 7/1/2009 7/1/2010 RAMAGE �eeEMESaupSce $ 350,000 CLAIMS MADE a OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 A X Independt Contractor BROAD FORM PD/CONTRACT ALL X XCU GENERAL AGGREGATE $ 4,000,000 A PER PROJECT AGG. CAP $20M GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,000 PRO - POLICY X JECT LOC A AUTOMOBILE LIABILITY ANY AUTO AS2-641-004218-029 7/1/2009 7/1/2010 COMBINED SINGLE LIMIT (Ea accident) $ 2'000'000 X BODILY INJURY (Per person) $ XXX)Cxxx ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ XXXXXXX HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ XXX}{X GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ XXXxxxx ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXX3XXX AUTO ONLY: AGG $ XXXXXXX EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ XXXXJCxx OCCUR CLAIMS MADE AGGREGATE $ XXXXXXX $ XX XXXXX _ UMBRELLA NOT APPLICABLE $ XXXXXXX DEDUCTIBLE FORM $ XXXXXXX RETENTION $ B WORKERS COMPENSATION AND WA7-64D-009004449 7/1/2009 7/1/2010 X I WC STATU- OTH- TORY LIMITS ER B EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE WC7-641-004218-019 (WI & OR) 7/1/2009 7/1/2010 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000>000 OFFICER/MEMBER EXCLUDED? If yes, describe under O N SPECIAL PROVISIONS below 1V E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: P-763, CIPP SANITARY AND STORM SEWERS (3RD YEAR OF TERM)). THE CITY OF FORT COLLINS, ITS OFFICERS, AGENTS AND EMPLOYEES ARE ADDITIONAL INSUREDS UNDER GENERAL LIABIILITY AND AUTOMOBILE LIABILITY AS REQUIRED BY WRITTEN CONTRACT, BUT ONLY WITH RESPECT TO LIABILITY ARISING OUT OF THE NAMED INSURED'S OPERATIONS. EXCEPTION TO CANCELLATION PROVISIONS: 10 DAYS FOR NONPAYMENT OF PREMIUM. XX 3731597 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF FORT COLLINS DATE THEREOF, THE ISSUING INSURER WILL "}4[%)MXX MAIL 10 DAYS WRITTEN 215 N. MASON STREET NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, FORT COLLINS CO 80524 WX•XX)0XXXTM)*KX11WWK(X rAg7{I X0pX X@6I KXAXMXX00) AUTHORIZED REPRESE ACORD 25 (2001/081 For questions redardind this certificate, contact the number listed in the 'Producer' section above and soecif t e'INSTE02'. ©A ORD CORPORATION 1988